Diagnostic prediction of ulcerative colitis using simplified endoscopic features and blood count-derived indices: a multicenter study
6 affiliations
- 1Guangxi University of Chinese Medicine, Nanning, Guangxi, China
- 2Department of Gastroenterology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
- 3Department of Gastroenterology, Guilin Hospital of Integrated Traditional Chinese and Western Medicine, Guilin, Guangxi, China
- 4Department of Gastroenterology, The Second Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, Guangxi, China
- 5Department of Gastroenterology, Guidong People’s Hospital of Guangxi Zhuang Autonomous Region, Wuzhou, Guangxi, China
- 6Department of Gastroenterology, Affiliated Wuxi Hospital of Nanjing University of Chinese Medicine, Wuxi, Jiangsu, China
Abstract
IntroductionFecal calprotectin (FC) results may be unavailable during assessment of inflammatory or ulcerative intestinal lesions. We assessed FC documentation and developed a diagnostic prediction model using endoscopic features and blood-derived inflammatory indices for ulcerative colitis (UC).MethodsWe retrospectively included 655 patients from four centers. Four prespecified logistic models were compared in complete cases (N = 455; 103 UC cases). Performance included discrimination, Brier score, calibration, and decision curves. Internal validation used 1,000 bootstrap resamples; transportability was assessed by leave-one-center-out cross-validation. LASSO-based analyses were exploratory; multiple imputation also assessed the robustness of the four primary models.ResultsFC was documented in 6 patients (0.9%). A model combining mucosal granularity, mucosal edema, neutrophil-to-lymphocyte ratio, and systemic immune-inflammation index had an apparent area under the receiver operating characteristic curve (AUC) of 0.739 (95% CI 0.684–0.795) and an optimism-corrected AUC of 0.733. It exceeded the blood-derived index model (AUC=0.594, P < 0.001) and simplified endoscopic model (AUC = 0.711, P = 0.024), but did not differ significantly from the three-item endoscopic model comprising vascular pattern abnormality, bleeding, and erosions/ulcers (AUC = 0.758, P = 0.521). At a cutoff of 0.155, Negative predictive value was 0.901. LASSO selected vascular pattern abnormality, bleeding, and mucosal granularity (optimism-corrected AUC = 0.746).DiscussionThe combined model showed moderate discrimination, with modest incremental value from blood-derived indices.
Related
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BibTeX
@article{sun2026diagnostic,
title = {{Diagnostic prediction of ulcerative colitis using simplified endoscopic features and blood count-derived indices: a multicenter study}},
author = {Yunlong Sun and Dongyu Cheng and Hairong Huang and Dongping Lai and Ri'an Xu and Dadong Wang and Hao Li and Linyan Shen and Tao Zhang},
journal = {Frontiers in Medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1991253},
url = {https://doi.org/10.3389/fmed.2026.1991253},
note = {CC BY},
}
RIS
TY - JOUR
TI - Diagnostic prediction of ulcerative colitis using simplified endoscopic features and blood count-derived indices: a multicenter study
AU - Yunlong Sun
AU - Dongyu Cheng
AU - Hairong Huang
AU - Dongping Lai
AU - Ri'an Xu
AU - Dadong Wang
AU - Hao Li
AU - Linyan Shen
AU - Tao Zhang
PY - 2026
DA - 2026/10/26
JO - Frontiers in Medicine
DO - 10.3389/fmed.2026.1991253
UR - https://doi.org/10.3389/fmed.2026.1991253
AB - IntroductionFecal calprotectin (FC) results may be unavailable during assessment of inflammatory or ulcerative intestinal lesions. We assessed FC documentation and developed a diagnostic prediction model using endoscopic features and blood-derived inflammatory indices for ulcerative colitis (UC).MethodsWe retrospectively included 655 patients from four centers. Four prespecified logistic models were compared in complete cases (N = 455; 103 UC cases). Performance included discrimination, Brier score, calibration, and decision curves. Internal validation used 1,000 bootstrap resamples; transportability was assessed by leave-one-center-out cross-validation. LASSO-based analyses were exploratory; multiple imputation also assessed the robustness of the four primary models.ResultsFC was documented in 6 patients (0.9%). A model combining mucosal granularity, mucosal edema, neutrophil-to-lymphocyte ratio, and systemic immune-inflammation index had an apparent area under the receiver operating characteristic curve (AUC) of 0.739 (95% CI 0.684–0.795) and an optimism-corrected AUC of 0.733. It exceeded the blood-derived index model (AUC=0.594, P < 0.001) and simplified endoscopic model (AUC = 0.711, P = 0.024), but did not differ significantly from the three-item endoscopic model comprising vascular pattern abnormality, bleeding, and erosions/ulcers (AUC = 0.758, P = 0.521). At a cutoff of 0.155, Negative predictive value was 0.901. LASSO selected vascular pattern abnormality, bleeding, and mucosal granularity (optimism-corrected AUC = 0.746).DiscussionThe combined model showed moderate discrimination, with modest incremental value from blood-derived indices.
SN - 2296-858X
ER -